Decreased sex drive is common among breast cancer survivors. There are several possible causes, including loss of a breast, depression, anxiety about recurrence, and effects of chemotherapy and hormonal treatments. A new study has found that topical testosterone cream does not increase sexual desire in breast cancer survivors.

Many survivors of breast cancer report having decreased sexual desire and drive. There are often several possible causes of diminished sex drive in women and it is difficult to know for certain which ones contributes the most.

There are no specific treatments for this problem, although a full evaluation for physical causes, such as vaginal dryness, early menopause, hormonal imbalance, or depression is usually recommended.

Loss of a breast, depression, anxiety about cancer coming back, and effects of chemotherapy and hormonal treatments all may play a role. Testosterone is known to increase female sexual drive but a recent study shows that increasing testosterone levels by applying a testosterone cream does not increase sex drive of women who survived breast cancer, according to a study published in the May 2 Journal of the National Cancer Institute.

Debra Barton, Ph.D., of Mayo Clinic in Rochester, MN, and colleagues gave 150 women who survived breast cancer either a testosterone cream or placebo (cream without medicine). The women were randomly assigned to either treatment daily for four weeks, then they were switched to the other treatment group for an additional four weeks. The researchers measured the women's sexual desire with a questionnaire before and after treatment.

There was no difference in sex drive between those who received testosterone and those who wound up with the placebo. Both groups showed increased sex drive after treatment, which suggests a placebo effect. The researchers thought that low estrogen levels may be important in causing low sex drive and that this cannot be corrected by giving testosterone.

In an accompanying editorial, Patricia Ganz, M.D., and Gail Greendale, M.D., of the Jonsson Comprehensive Cancer Center at the School of Public Health and the David Geffen School of Medicine at the University of California, Los Angeles, discuss the complexities of sexual desire and response in women. They write that, causes of diminished sexual desire in women who survived breast cancer are complex and, although hormone levels are important, other factors are also important. Increasing testosterone levels by itself appears not to be effective and other causes need also to be considered and addressed.

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